My Company

By Kathryn Mayer

Medicaid managed care programs appear ready to take on new enrollees next year, according to a new report.

Researchers from the Urban Institute conducted interviews in eight states that plan on expanding their Medicaid programs under health reform — Maryland, Michigan, Minnesota, New Mexico, New York, Oregon, Rhode Island, and Virginia — and found that most health care stakeholders think managed care programs will “easily” take on the increased number of Medicaid enrollees.

The authors say the readiness of managed care programs is key as they already serve a significant portion of Medicaid enrollees and the numbers will increase after expansion.

Under the Patient Protection and Affordable Care Act, states have the option of expanding Medicaid eligibility at a low cost to people with incomes of up to 133 percent of the federal poverty level. The Supreme Court ruling last year left the decision to expand the health care program for low-income people up to the states themselves, and many Republican-led states have refused to do so, citing ballooning costs.

Still, Medicaid expansion has been more popular than the health care law in general.

“Millions of uninsured people will gain coverage when the Medicaid expansion kicks in early next year,” said Andy Hyman, who leads health coverage programs at the Robert Wood Johnson Foundation, the group that funded the new report. “States’ Medicaid managed care programs will serve the majority of these new enrollees, so they need to be prepared to help care for more people. The good news is that the programs are ready for all comers.”

The states did however express concern about the ability of states’ information technology systems to "seamlessly handle an increased volume of eligibility and enrollment process."

Most of those interviewed said steps need to be taken immediately to put adequate IT systems in place before 2014.